Joyce Myers Trust Fund

JOYCE MYERS TRUST FUND

Scholarship Application 2017

The Joyce Myers Board of Trustees has implemented a scholarship to curlers who have enrolled full time in a post secondary institution in Atlantic Canada. The intention of these awards is to allow talented athletes to devote primary sources of time and energy to training, rather than extensive employment in order to fund post-secondary education. Recipients will be expected to devote a full-time, shared commitment to sport and education exclusively. This award is not intended to reward past achievements but rather a means to pursue further achievements that surpass the current level of performance. Priority will be given to athletes attending Atlantic universities, colleges or vocational schools.

Please complete the following application, scan and email to the Joyce Myers Trust Fund c/o: ,by May15th, 2017. Along with your application please include a copy of your university or high school transcript and one other letter of reference other than your coach. Disbursement of funds to the successful applicants will occur on October 1, 2017, upon receipt of enrolment confirmation.

General Information

SurnameFirst Name

Mailing Address (Street/P.O. Box) (Address to which correspondence should be sent)

City/TownPostal Code

Telephone: (H) __ (W) E-Mail Address: ______

Parents / Guardians Names

Telephone: (H) (W) ______

Picture Enclosed (please ensure name is printed on the back)

Birth Date: \ \  MaleFemale

YearMonthDay

Educational Status: Not Attending School Post Secondary (Year of Study ______

High School(Present Grade ___  Other

If Other, please specify: ______

Employment Status: Full-time Part-time Presently Unemployed Student

For Post Secondary Student Athletes Only

Name of Institution: ______

Faculty/Degree Program: Major: ______

Full-time Student Part-time StudentAttending from: \ to \ ______MonthYearMonthYear

Athletic Performance

PROVINCIAL PERFORMANCE
EVENT / DATE / PLACING / # OF ENTRIES IN COMPETITION
NATIONAL PERFORMANCE
EVENT / DATE / PLACING / # OF ENTRIES IN COMPETITION

INTERNATIONAL PERFORMANCE

EVENT / DATE / PLACING / # OF ENTRIES IN COMPETITION

Performance Goals

(A) In the space provided, please describe your performance goals for the next 1 – 2 years.

______

______

______

______

______

______

______

(B)Please describe your competition, training and educational plans for the next 1 – 2 years that will enable you to achieve the goals you identified above.

______

______

______

______

______

______

______

Estimate of Training Costs (Sept. 2017 - Aug. 2018)

Training Costs: (gym fees, personal trainer, special equipment, personal gym)

1. $ ______

2. $ ______

3. $______

Competition Costs: (Travel, Hotel, Registration Fees, etc.)

1. $ ______

2. $ ______

3. $______

Other Expenses: (equipment, tuition fees, additional living expenses, camps, etc.)

1. $ ______

2. $ ______

3. $______

TOTAL$______

* Attach additional information if necessary.

Present Funding Sources

Please list the sources of funding for your present training and competition costs including bursaries, scholarships, sponsorships, grants, remuneration or other financial assistance received for athletic or educational endeavours.

FUNDING SOURCEDESCRIPTIONAMOUNT

$ ______

$______

$ ______

$______

Applicant’s Signature ______Date ______

Any Additional Comments: ______

______

______

References

(A) FOR COMPLETION BY COACH ONLY

______

SurnameGiven Names

______

Current Mailing Address (Street/P.O. Box)

______

City/TownPostal Code

Telephone: (B) (H) ______

This will confirm that the applicant, , is presently training and competing in the sport

Name

of under the guidance and training of the undersigned.

Sport

______

Coach’s SignatureDate

Comments: ______

______

(B)PLEASE ATTACH A LETTER OF REFERENCE FROM A PERSON OTHER THAN YOUR COACH.

(C)FOR COMPLETION BY PROVINCIAL SPORT ORGANIZATION ONLY

NAME OF PROVINCIAL SPORT ORGANIZATION: ______

Date application received by Provincial Sport Organization: \ \ ______

YearMonthDay

Athlete’s ranking for assistance within your sport: (i.e. first, second, third, etc): ______

Male and female athletes must be ranked together.

______

Signature of President, Provincial Sport OrganizationDate

Checklist

Ensure the following are completed before submitting your application:

Picture enclosed

Application signed

Performance section completed

Letter of Reference

Copy of Transcript

Coach’s signature